Achieving Gastric Sleeve Success

All prospective gastric sleeve patients of course want to achieve great gastric sleeve success. This means getting a great long-term weight loss outcome, and avoiding complications.

The published studies, unfortunately, show that this doesn’t always happen. Many patients achieve excellent, long-term gastric sleeve success, but some don’t. It is important to understand that great outcomes don’t just happen. Great outcomes are made to happen, by the patient, and by the surgeon.

In this post I discuss the patient’s role in achieving gastric sleeve success. This discussion is equally applicable to achieving success after gastric bypass surgery. In other posts (here, here, here) I discuss the surgeon’s role in achieving great gastric sleeve outcomes.

Surgery Lowers the Body Weight Set-Point

The fundamental thing that weight loss surgery (gastric bypass, sleeve gastrectomy) does is reset the body weight set-point to a lower weight (more here). This is what enables initial weight loss, and more importantly, long-term maintenance of weight loss.*

Everybody has a body weight set-point. The set-point is the lowest weight at which the body is biologically “happy.” If you lose weight to below your set-point, your body will react by increasing hunger, increasing appetite, increasing cravings, and decreasing metabolism. The purpose of these changes is to bring body weight back up to the biologic set-point.

The set-point is what prevents people from being able to easily lose weight and what makes the long-term maintenance of weight loss virtually impossible (more here).

Only surgery lowers the body weight set-point. Diet programs, exercise programs, and medications do not lower the set-point. This is the reason why surgery is so much more effective for long-term weight loss than any other weight loss method.*

What Surgery Doesn’t Do

What weight loss surgery doesn’t do is change the reasons for why weight gain can occur. Surgery doesn’t change genetics, and surgery doesn’t prevent bad eating habits.

If a person is genetically prone to weight gain, extra calories consumed are stored as fat. And unfortunately, when weight is gained, the set-point will quickly ratchet up to the new higher weight.

This is how the disease of obesity develops. A combination of excess calorie intake and genetics results in weight gain and an elevated body weight set-point.

This same sequence of events can happen after surgery. Poor eating habits can very easily result in excess calorie intake, maybe not in the first 1-2 years after surgery, but eventually. This will cause weight gain and an increased set-point just like it did before surgery.

Surgery Is a Do-Over, Not a Cure

Surgery is a do-over; it will reset your body-weight set-point to a lower weight, giving you a second chance to maintain a healthy weight long-term. The key to gastric sleeve success (because you can’t change your genetics) is establishing healthy eating habits.*

Patients who achieve good long-term gastric sleeve success typically have good eating habits, and patients who do not achieve good long-term gastric sleeve success typically have the same bad habits that caused weight gain before surgery.*

In general, good habits after surgery consist of eating 3-4 regularly scheduled, portion-controlled meals per day consisting primarily of healthy, low calorie foods – lean protein, vegetables, fruits, whole grains, low fat dairy. Less desirable choices include most processed carbs, foods with added sugar/fat, and high calorie liquids. Snacking/grazing should be avoided.

Achieving Gastric Sleeve Success

If the goal is to achieve great long-term gastric sleeve success, patients must be willing/motivated/capable of establishing and maintaining appropriate eating habits after surgery. This is generally the most important determinant of whether a prospective patient is a good candidate for gastric sleeve surgery.*


Weight loss surgery is a great tool for weight loss because it resets the body weight set-point to a lower weight. Nothing else does this. This makes weight loss and long-term maintenance of weight loss possible.*

What surgery doesn’t do is change the reasons for why weight gain (genetics, poor eating habits) can occur. The long-term challenge after surgery for patients is maintaining the set-point at the new lower weight. The key to doing this is maintaining appropriate eating habits.*

Learn More

Learn more about Dr. Oliak and his Orange County weight loss surgery program at

* Patient results vary after weight loss surgery. Individual patients can lose more or less weight than the average.

More Weight Loss Surgery Resources


David Oliak, M.D.

Dr. Oliak is a board-certified, fellowship-trained surgeon who specializes in minimally invasive (laparoscopic and robotic) weight loss surgery. He has been in practice in Orange County, California, since 2002, has completed more than 3000 operations, and has a track record of excellent patient outcomes.*

Dr. David Oliak is Director and Chief of the accredited bariatric surgery center of excellence (COE) program at Placentia-Linda Hospital in Orange County. Prior to this, he was the medical director for bariatric surgery and chairman for the Department of Surgery at Chapman Global Medical Center in Orange.

*Individual results may vary. Past performance is not a guarantee of future results.

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